|(a) A CMA must ensure that:
(1) a full-time case manager is assigned to provide
case management to no more than 50 individuals at one time;
(2) a part-time case manager is assigned to provide
case management to no more than 25 individuals at one time; and
(3) for a month in which a case manager does not meet
with an individual or LAR as required by §45.223(a) of this chapter
(relating to Renewal and Revision of an IPC), the case manager has
a face-to-face or telephone contact with the individual or LAR or
other persons acting on behalf of the individual, such as an advocate
or family member, to provide case management.
(b) In determining the number of individuals to which
a case manager will be assigned, the CMA must take into consideration
the intensity of an individual's needs, the frequency and duration
of contacts the case manager will need to make with the individual,
and the amount of travel time involved in making such contacts.
(c) A CMA must have:
(1) an adequate number of case managers available to
ensure the provision of case management to an individual at all times;
(2) a written process that ensures that case managers
are or can readily become familiar with individuals to whom they are
not ordinarily assigned but to whom they may be required to provide
(d) A CMA must ensure that a case manager participates
as a member of an individual's service planning team in accordance
with this chapter and the CLASS Provider
(e) A CMA must ensure that case management is provided
to an individual in accordance with the individual's IPC.
(f) A CMA must submit an IPC to DADS within the time
periods required by §45.214 of this chapter (relating to Development
of Enrollment IPC) and §45.223(f)(2) of this chapter (relating
to Renewal and Revision of an IPC) to ensure that a DSA receives reimbursement
for the provision of CLASS Program services and CFC services.
(g) A CMA must follow the process for requesting authorization
to purchase dental treatment as described in the CLASS Provider Manual.
(h) If an individual may need cognitive rehabilitation
therapy, a case manager must assist the individual in obtaining, in
accordance with the Medicaid State Plan, a neurobehavioral or neuropsychological
assessment and plan of care from a qualified professional as a non-CLASS
|Source Note: The provisions of this §45.705 adopted to be effective March 21, 2011, 36 TexReg 1840; amended to be effective July 1, 2015, 40 TexReg 2768; amended to be effective March 20, 2016, 41 TexReg 1952